Table 1.

Inclusion and exclusion criteria.

Inclusion Criteria

Exclusion Criteria

Adults age ≥18 or <70 years Liver biopsy ≤6 months prior to enrollment Biopsy proven NASH [45] Lack of secondary causes of hepatic fat accumulation: •Significant alcohol consumptiona •Chronic hepatitis C •Wilson disease •Lipodystrophy •Parenteral nutrition •Long-term use of steatogenic medicationsb •Monogenic hereditary disorders

>90 min/week of at least moderate intensity exercise over the previous three months Pregnancy BMI <18 or >45 kg/m2 [50] Uncontrolled diabetes [31]c Active cardiac symptoms Severe medical comorbidities/psychiatric illness Decompensated cirrhosisd Cancer with life expectancy <6 months MRI contraindications Other liver disease Active weight-loss program participation or weight-loss supplement use Active substance abuse/smoking Inability to provide informed consent Institutionalized/prisoner Inability to walk >2 blocks or 1/4 mile Non-English-speaking patientse Anticoagulants excluding 81 mg of aspirin daily

BMI = body mass index; MRI = magnetic resonance imaging; NASH = nonalcoholic steatohepatitis.

^a<21drinks/week for men and <14 drinks/week for women.

^bMipomersen, lomitapide, amiodarone, methotrexate, tamoxifen, corticosteroids.

^cChanges in medication dosing over the previous three months or hemoglobin A1c >9%.

^dBleeding gastroesophageal varices, ascites or hepatic encephalopathy.

^eDue to unavailability of translators for all visits/sessions.